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THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN 401k Plan overview

Plan NameTHE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN
Plan identification number 501

THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

THE COUNCIL ON RECOVERY has sponsored the creation of one or more 401k plans.

Company Name:THE COUNCIL ON RECOVERY
Employer identification number (EIN):741173235
NAIC Classification:541990
NAIC Description:All Other Professional, Scientific, and Technical Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-06-01MONICA BROWN-BROUSSARD2023-12-14
5012021-06-01
5012020-06-01
5012019-06-01
5012018-06-01
5012017-06-01WILLIAM M. TAYLOR
5012016-06-01WILLIAM M. TAYLOR
5012015-06-01WILLIAM M. TAYLOR
5012014-06-01JOEL FERGUSON
5012010-06-01JOEL FERGUSON
5012009-06-01JOEL FERGUSON

Plan Statistics for THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN

401k plan membership statisitcs for THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN

Measure Date Value
2021: THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-06-0162
Total number of active participants reported on line 7a of the Form 55002021-06-0158
Total of all active and inactive participants2021-06-0158
2020: THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-06-01135
Total number of active participants reported on line 7a of the Form 55002020-06-01105
Number of retired or separated participants receiving benefits2020-06-012
Total of all active and inactive participants2020-06-01107
Total participants2020-06-01107
2019: THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-06-01145
Total number of active participants reported on line 7a of the Form 55002019-06-01135
Total of all active and inactive participants2019-06-01135
Total participants2019-06-01135
Number of participants with account balances2019-06-010
2018: THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-06-01163
Total number of active participants reported on line 7a of the Form 55002018-06-01145
Total of all active and inactive participants2018-06-01145
Total participants2018-06-01145
2017: THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-06-01102
Total number of active participants reported on line 7a of the Form 55002017-06-0193
Number of retired or separated participants receiving benefits2017-06-011
Total of all active and inactive participants2017-06-0194
Total participants2017-06-0194
2016: THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-06-01100
Total number of active participants reported on line 7a of the Form 55002016-06-0192
Number of retired or separated participants receiving benefits2016-06-015
Number of other retired or separated participants entitled to future benefits2016-06-0111
Total of all active and inactive participants2016-06-01108
Total participants2016-06-01108
2015: THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-06-01116
Total number of active participants reported on line 7a of the Form 55002015-06-01109
Total of all active and inactive participants2015-06-01109
Total participants2015-06-010
2014: THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-06-01104
Total number of active participants reported on line 7a of the Form 55002014-06-01114
Number of retired or separated participants receiving benefits2014-06-011
Total of all active and inactive participants2014-06-01115
Total participants2014-06-010
2010: THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-06-0178
Total number of active participants reported on line 7a of the Form 55002010-06-0178
Total of all active and inactive participants2010-06-0178
Total participants2010-06-0178
2009: THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-06-0178
Total number of active participants reported on line 7a of the Form 55002009-06-0187
Total of all active and inactive participants2009-06-0187
Total participants2009-06-0187

Form 5500 Responses for THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN

2021: THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-06-01Type of plan entitySingle employer plan
2021-06-01Plan funding arrangement – InsuranceYes
2021-06-01Plan funding arrangement – General assets of the sponsorYes
2021-06-01Plan benefit arrangement – InsuranceYes
2020: THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-06-01Type of plan entitySingle employer plan
2020-06-01Plan funding arrangement – InsuranceYes
2020-06-01Plan funding arrangement – General assets of the sponsorYes
2020-06-01Plan benefit arrangement – InsuranceYes
2019: THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-06-01Type of plan entitySingle employer plan
2019-06-01Plan funding arrangement – InsuranceYes
2019-06-01Plan funding arrangement – General assets of the sponsorYes
2019-06-01Plan benefit arrangement – InsuranceYes
2018: THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-06-01Type of plan entitySingle employer plan
2018-06-01Plan funding arrangement – InsuranceYes
2018-06-01Plan funding arrangement – General assets of the sponsorYes
2018-06-01Plan benefit arrangement – InsuranceYes
2017: THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-06-01Type of plan entitySingle employer plan
2017-06-01Plan funding arrangement – InsuranceYes
2017-06-01Plan funding arrangement – General assets of the sponsorYes
2017-06-01Plan benefit arrangement – InsuranceYes
2016: THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-06-01Type of plan entitySingle employer plan
2016-06-01Plan funding arrangement – InsuranceYes
2016-06-01Plan funding arrangement – General assets of the sponsorYes
2016-06-01Plan benefit arrangement – InsuranceYes
2015: THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-06-01Type of plan entitySingle employer plan
2015-06-01Plan funding arrangement – InsuranceYes
2015-06-01Plan funding arrangement – General assets of the sponsorYes
2015-06-01Plan benefit arrangement – InsuranceYes
2014: THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-06-01Type of plan entitySingle employer plan
2014-06-01Plan funding arrangement – InsuranceYes
2014-06-01Plan funding arrangement – General assets of the sponsorYes
2014-06-01Plan benefit arrangement – InsuranceYes
2010: THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN 2010 form 5500 responses
2010-06-01Type of plan entitySingle employer plan
2010-06-01Plan funding arrangement – InsuranceYes
2010-06-01Plan funding arrangement – General assets of the sponsorYes
2010-06-01Plan benefit arrangement – InsuranceYes
2009: THE COUNCIL ON ALCOHOL AND DRUGS HOUSTON WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-06-01Type of plan entitySingle employer plan
2009-06-01Plan funding arrangement – InsuranceYes
2009-06-01Plan funding arrangement – General assets of the sponsorYes
2009-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5972107
Policy instance 3
Insurance contract or identification number5972107
Number of Individuals Covered100
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $3,078
Total amount of fees paid to insurance companyUSD $419
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,330
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,078
Amount paid for insurance broker fees34
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number884765G
Policy instance 2
Insurance contract or identification number884765G
Number of Individuals Covered81
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $6,299
Total amount of fees paid to insurance companyUSD $1,090
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $41,993
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,299
Insurance broker organization code?3
Amount paid for insurance broker fees1005
Additional information about fees paid to insurance brokerBONUS
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0605190
Policy instance 1
Insurance contract or identification number0605190
Number of Individuals Covered97
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $497
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $620,614
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $296
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0605190
Policy instance 1
Insurance contract or identification number0605190
Number of Individuals Covered105
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $1,961
Total amount of fees paid to insurance companyUSD $2,490
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $642,356
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,961
Amount paid for insurance broker fees2490
Additional information about fees paid to insurance broker2020 PINNACLE MEDICAL RISK RETENTION INCENTIVE RISK
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number884765G
Policy instance 2
Insurance contract or identification number884765G
Number of Individuals Covered85
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $6,542
Total amount of fees paid to insurance companyUSD $1,077
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $43,616
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,542
Insurance broker organization code?3
Amount paid for insurance broker fees1077
Additional information about fees paid to insurance brokerBONUS
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5972107
Policy instance 3
Insurance contract or identification number5972107
Number of Individuals Covered68
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $2,844
Total amount of fees paid to insurance companyUSD $355
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,742
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,844
Insurance broker organization code?3
Amount paid for insurance broker fees355
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
SAFEGUARD HEALTH PLANS, INC. A TEXAS CORPORATION (National Association of Insurance Commissioners NAIC id number: 95051 )
Policy contract number5972107
Policy instance 4
Insurance contract or identification number5972107
Number of Individuals Covered46
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $375
Total amount of fees paid to insurance companyUSD $47
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,185
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $375
Insurance broker organization code?3
Amount paid for insurance broker fees47
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0605190
Policy instance 1
Insurance contract or identification number0605190
Number of Individuals Covered135
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $4,581
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $808,398
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,581
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number884765G
Policy instance 2
Insurance contract or identification number884765G
Number of Individuals Covered90
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $6,807
Total amount of fees paid to insurance companyUSD $1,024
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $45,382
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,807
Insurance broker organization code?3
Amount paid for insurance broker fees1024
Additional information about fees paid to insurance brokerBONUS
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number28538
Policy instance 3
Insurance contract or identification number28538
Number of Individuals Covered69
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $477
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,950
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $477
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0605190
Policy instance 1
Insurance contract or identification number0605190
Number of Individuals Covered119
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $2,975
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $884,011
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,975
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number884765G
Policy instance 2
Insurance contract or identification number884765G
Number of Individuals Covered101
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $6,444
Total amount of fees paid to insurance companyUSD $524
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $42,960
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,444
Insurance broker organization code?3
Amount paid for insurance broker fees524
Additional information about fees paid to insurance brokerBONUS
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number28538
Policy instance 3
Insurance contract or identification number28538
Number of Individuals Covered63
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $664
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,071
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $664
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0605190
Policy instance 4
Insurance contract or identification number0605190
Number of Individuals Covered149
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $4,990
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $50,873
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,990
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0605190
Policy instance 4
Insurance contract or identification number0605190
Number of Individuals Covered167
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $4,491
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $49,195
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number28538
Policy instance 3
Insurance contract or identification number28538
Number of Individuals Covered151
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $594
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,825
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00447094
Policy instance 2
Insurance contract or identification number00447094
Number of Individuals Covered104
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $7,366
Total amount of fees paid to insurance companyUSD $2,814
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D, OPTIONAL AD&D, OPTIONAL LIFE
Welfare Benefit Premiums Paid to CarrierUSD $49,107
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0605190
Policy instance 1
Insurance contract or identification number0605190
Number of Individuals Covered138
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $911,978
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0605190
Policy instance 1
Insurance contract or identification number0605190
Number of Individuals Covered97
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $697,545
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSION
Insurance broker organization code?3
Insurance broker nameMARSH & MCLENNON AGENCY LLC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00447094
Policy instance 2
Insurance contract or identification number00447094
Number of Individuals Covered173
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $18,199
Total amount of fees paid to insurance companyUSD $6,588
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D, OPTIONAL AD&D, OPTIONAL LIFE
Welfare Benefit Premiums Paid to CarrierUSD $144,336
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,199
Amount paid for insurance broker fees6588
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
Insurance broker organization code?3
Insurance broker nameMARSH & MCLENNON AGENCY LLC
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number28538
Policy instance 3
Insurance contract or identification number28538
Number of Individuals Covered144
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $617
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,299
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $617
Insurance broker organization code?3
Insurance broker nameMC&H LIFE AGENCY, INC.
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0605190-AUSTIN
Policy instance 4
Insurance contract or identification number0605190-AUSTIN
Number of Individuals Covered33
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $195,633
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number000BG628
Policy instance 2
Insurance contract or identification number000BG628
Number of Individuals Covered218
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $12,204
Total amount of fees paid to insurance companyUSD $3,439
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $53,409
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,204
Amount paid for insurance broker fees3439
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
Insurance broker organization code?3
Insurance broker nameMC&H LIFE AGENCY, INC.
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number28538
Policy instance 3
Insurance contract or identification number28538
Number of Individuals Covered155
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $585
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,162
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $585
Insurance broker organization code?3
Insurance broker nameMC&H LIFE AGENCY, INC.
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0605190
Policy instance 1
Insurance contract or identification number0605190
Number of Individuals Covered184
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $4,148
Total amount of fees paid to insurance companyUSD $45,082
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $859,484
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,148
Amount paid for insurance broker fees45082
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSION
Insurance broker organization code?3
Insurance broker nameMC&H LIFE AGENCY, INC.
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05734639
Policy instance 2
Insurance contract or identification numberTM05734639
Number of Individuals Covered73
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $1,766
Total amount of fees paid to insurance companyUSD $353
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,773
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SAFEGUARD HEALTH PLANS, INC. A TEXAS CORPORATION (National Association of Insurance Commissioners NAIC id number: 95051 )
Policy contract numberTM05734639
Policy instance 3
Insurance contract or identification numberTM05734639
Number of Individuals Covered102
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $920
Total amount of fees paid to insurance companyUSD $184
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,227
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number622162
Policy instance 4
Insurance contract or identification number622162
Number of Individuals Covered116
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $48,649
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95490 )
Policy contract numberUS317131
Policy instance 5
Insurance contract or identification numberUS317131
Number of Individuals Covered141
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $28,645
Welfare Benefit Premiums Paid to CarrierUSD $577,768
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number28538
Policy instance 1
Insurance contract or identification number28538
Number of Individuals Covered112
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $484
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,760
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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